NPI age
4 years
Enumerated 2021-12-10
● Active
Type 1 · Individual
Miranda Michelle Van Dam, CSFA
Van Dam is 1 of 13 specialist/technologist, other providers in Meridian and 1 of 52 in Idaho.
Primary specialty
Specialist/Technologist, Other
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2021-12-10
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 52 active specialist/technologist, other providers in Idaho.
NPI age
4 years
≈ at median (3 yr)
State licenses
1 state
0% of peers hold multiple states
Subspecialties
0
11% of peers hold subspecialties
NPI lifetime · 2021 → 2026
2021-12Enumerated in NPPES
2021
2026
Where they practice
Practice location
500 S. Eagle Rd.
Meridian, ID 83642
Mailing address
3595 W Spruce Creek Dr
Meridian, ID 836424217
Specialties
-
Specialist/Technologist, Other PrimaryA surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 205983 | NATIONAL BOARD OF SURGICAL TECHNOLOGY AND SURGICAL ASSISTING |
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
Recently enumerated nearby: 3 new specialist/technologist, other providers have been added in Meridian in the last 180 days.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.